JUSTIFICATION OF OBSTRUCTIVE RESECTION OF THE FINE INTESTINE WITH MESENTERIAL THROMBOSIS
Acute mesenteric ischemia is abdominal catastrophe with a high incidence of lethal outcomes. A staged surgical treatment for acute mesenteric ischemia, with a focus on discussing common methods used to treat this disease are discussed in this paper. The patients were divided into two groups. In group I, 122 patients were included who underwent resection of the colon and small intestine with primary anastomosis in the stage of infarction and peritonitis. Group II included 42 patients who also underwent obstructive resection of the small and large intestine without imposing a primary anastomosis; the inter-intestinal anastomosis is superimposed after the relief of peritonitis. Comparison of groups by gender, age, stages of the disease, the degree of preoperative risk, the volume of intestinal lesions, the duration of the disease before hospitalization was carried out. In addition, the comorbidity index, MIP score, was calculated. Groups were comparable in all parameters. The average duration of operations in group II was 1.4 times shorter than in group I. The average number of days the patients were in RAW in Group I was 5.2 ± 2.2 days, in Group II - 7.2 ± 2.4 days. The duration of hospital stay for patients in group I was 20.4 ± 3.2, in group II 10.5 ± 5.4 days. The imposition of interstitial anastomosis in a delayed manner, allowed to reduce the inconsistency of the inter-intestinal anastomosis from 98 (80%) to 9 (21.3%), 2 times to reduce the likelihood of the development of peritonitis. Performing obstructive resection of the small and large intestine with delayed anastomosis in patients with acute mesenteric thrombosis in the stage of heart attack and peritonitis can reduce the duration of the surgical procedures, follow the bowel viability, in time to resect necrotic altered bowel areas, impose intestinal anastomosis in a docked peritonitis, leading to decrease in postoperative mortality from 90.0 to 21.3%. It is an effective element in the treatment of patients with acute mesenteric thrombosis.
Keywords
тромбоз верхней брыжеечной артерии, Мангеймский индекс перитонита, некроз кишечника, перитонит, индекс коморбидности Charlson, межкишечный анастомоз, thrombosis of the superior mesenteric artery, Mannheim Peritonitis Index, intestinal necrosis, peritonitis, Charlson Comorbidity Index, inter-intestinal anastomosisAuthors
| Name | Organization | |
| Katasheva L.Yu. | Novokuznetsk State Institute Advanced Medical Training - Branch of the Russian Medical Academy of Continuing Professional Education | lylia_kem@mail.ru |
| Baranov A.I. | Novokuznetsk State Institute Advanced Medical Training - Branch of the Russian Medical Academy of Continuing Professional Education | |
| Yaroshchuk S.A. | Novokuznetsk City Clinical Hospital No 29 | |
| Shurygina E.I. | Novokuznetsk State Institute Advanced Medical Training - Branch of the Russian Medical Academy of Continuing Professional Education |
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